Diagnostic comparison of malaria infection in peripheral blood, placental blood and placental biopsies in Cameroonian parturient women
Diagnostic comparison of malaria infection in peripheral blood, placental blood and placental biopsies in Cameroonian parturient women
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DOI：
10.1186/1475-2875-8-126
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发表时间：
2009-06-08
期刊：
影响因子：
3
通讯作者：
Troye-Blomberg, Marita
中科院分区：
文献类型：
--
作者：
Anchang-Kimbi, Judith K.;Achidi, Eric A.;Troye-Blomberg, Marita
背景：在撒哈拉以南非洲，妊娠期恶性疟原虫疟疾是一个巨大的诊断挑战。不同类型的疟疾诊断的流行病学和临床相关性，以及与疟疾感染相关的危险因素在delivery.Method：在横断面调查中，306名妇女报告交付Mutenegene产科诊所，法科师，西南省，喀麦隆进行了筛选，恶性疟原虫外周血，胎盘血和胎盘组织切片显微镜。结果：在这些孕妇中，外周血、胎盘血和胎盘组织切片中恶性疟原虫感染的检出率分别为5.6%、25.5%和60.5%。胎盘组织学检查的敏感性（97.4%）高于胎盘血涂片（41.5%）和外周血（8.0%）。在多变量分析中，年龄（≥ 2次SP剂量）（OR = 0.18，95% CI = 0.06 - 0.52）与分娩时显微镜下寄生虫血症患病率显著降低相关。年龄（> 20岁）（OR = 0.34，95%CI = 0.15 - 0.75）是单因素分析中与组织学诊断的寄生虫血症相关的唯一显著危险因素。显微寄生虫血症（OR = 2.74，95%CI = 1.33 ~ 5.62）是孕妇分娩时贫血的重要危险因素，但单纯组织学检查和既往感染均与贫血风险增加无关。显微镜下检测到的寄生虫血症与分娩时母体贫血风险增加相关，但仅通过胎盘组织学检测到的低度寄生虫血症无关。
Background: In sub-Saharan Africa, Plasmodium falciparum malaria in pregnancy presents an enormous diagnostic challenge. The epidemiological and clinical relevance of the different types of malaria diagnosis as well as risk factors associated with malaria infection at delivery were investigated.Method: In a cross-sectional survey, 306 women reporting for delivery in the Mutenegene maternity clinic, Fako division, South West province, Cameroon were screened for P. falciparum in peripheral blood, placental blood and placental tissue sections by microscopy. Information relating to the use of intermittent preventive treatment in pregnancy with sulphadoxine/pyrimethamine, history of fever attack, infant birth weights and maternal anaemia were recorded.Results: Among these women, P. falciparum infection was detected in 5.6%, 25.5% and 60.5% of the cases in peripheral blood, placental blood and placental histological sections respectively. Placental histology was more sensitive (97.4%) than placental blood film (41.5%) and peripheral blood (8.0%) microscopy. In multivariate analysis, age (= 2 SP doses (OR = 0.18, 95% CI = 0.06 - 0.52) was associated with a significant reduction in the prevalence of microscopic parasitaemia at delivery. Age (> 20 years) (OR = 0.34, 95% CI = 0.15 - 0.75) was the only significant risk factor associated with parasitaemia diagnosed by histology only in univariate analysis. Microscopic parasitaemia (OR = 2.74, 95% CI = 1.33 - 5.62) was a significant risk factor for maternal anaemia at delivery, but neither infection detected by histology only, nor past infection were associated with increased risk of anaemia.Conclusion: Placenta histological examination was the most sensitive indicator of malaria infection at delivery. Microscopically detected parasitaemia was associated with increased risk of maternal anaemia at delivery, but not low-grade parasitaemia detected by placental histology only.